7. In patients requiring mechanical ventilation for >48 h, does topical application of nonabsorbable antimicrobials (antibiotics or chlorhexidine) in the oropharynx (SOD) or in the oropharynx and intestinal tract along with intravenous antibiotics (SDD) reduce the risk of VAP occurrence and/or improve patient outcome compared with standard care?

No recommendation for chlorhexidine, but suggest to use it.

Against systemic antibiotics (SDD)

DIFFERENCES FROM ATS/ IDSA GUIDELINES

There are different definitions for VAP and HAP.

Use of ventilator bundles is more popular in the United States.

Due to presence of prior authorization for use of broad-spectrum antibiotics, Broad-spectrum antibiotics infrequently used in Europe. IDSA/APS guidelines recommend targeting at least 95% of the potential organisms.